20 October 2020
The ARC Wessex COVID Health Systems research team has supported the University of Southampton IT Innovation Centre in a successful bid to NHSX with North and Mid Hants Integrated Care Partnership and the Wessex Academic Health Sciences Network to deploy and scale remote community monitoring in COVID-19 Virtual Wards for patient emergency care.
COVID-19 has forced rapid, accelerated change within the NHS to embrace digital innovations such as remote consultation and remote monitoring. Remote interactions not only reduce infection rates by reducing physical contact but offer news ways of delivering emergency care.
A COVID-19 virtual ward is one such innovation, and is simply a way for clinicians to remotely monitor patients at home, avoiding the need for attendances to GP practices or hospital.
Community monitoring is important for early identification of patient deterioration and timely and appropriate interventions, including escalations to higher levels of acute care through hospital admissions. It is also important for rapid follow up of patients post hospital discharge particularly for those frail, elderly and vulnerable patients with multiple long-term conditions at high risk of adverse complication events and readmission to hospital.
Dr Matt Inada-Kim, National Clinical Lead Deterioration & National Specialist Advisor Sepsis, NHS England and NHS Improvement, and Emergency Consultant at Hampshire Hospitals Foundation Trust, says
“A characteristic of COVID-19 is that some patients suffer from silent hypoxia where oxygen saturation levels fall to dangerously low levels without noticeable difficulties when breathing. During the 1st wave, patients were arriving at hospital in a serious condition, significantly more poorly than their symptoms would suggest. RECOxCARE aims to empower patients with oximetry at home and allow clinicians to spot early deterioration, initiate timely escalation and reduce mortality risk“
Professor Michael Boniface, Director of the University of Southampton IT Innovation Centre, and leader of the RECOxCARE digital work stream says
“The technology to remotely observe oximetry, vital signs and symptoms is relatively straight forward, but rapidly integrating observation data into safe clinical processes and across different primary and secondary clinical context raises significant challenges of interoperability and timely access to data needed for direct care.” Prof Boniface continues that
“Monitoring oximetry and other risk factors over the full disease trajectory also allows for greater understanding of COVID-19 and for better clinical models to be developed. Through the Wessex ARC PPDRCOM project (Predicting Patient Deterioration in Communities) we will exploring how predictive analytics techniques can be used to understand which COVID-19 patients are at most risk in different care settings” Read Michael's Quality Improvement report (An Evidence-Based Approach to Quality Improvement for COVIDoximetry@home) below
The RECOxCARE project is funded by NHSX as part of a South East Regional scale programme to support people at home through report monitoring.
See Dr Matt Inada-Kim's webinar on remote Pulse Oximetry below or read the latest publication